Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Paddock Lake Family Practice, SC

Organization Family Medicine Physician · NPI 1417919275

Paddock Lake Family Practice, SC is a Family Medicine Physician in Salem, Wisconsin. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

7137 236th Ave Ste 103
Salem, WI 53168-9664
Phone: (262) 843-4422
Fax: (262) 843-1166
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1417919275
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lisa Thomas — Billing Manager · (262) 843-2394
NPI enumeratedApril 5, 2006
Last updated in NPPESApril 20, 2008
Mailing address7137 236th Ave, Suite 103, Salem, WI 53168-9664

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